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Neonatology Flashcards

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1
Q

Why might newborn infants need special medical care?

A 
Prematurity
Low birth weight
Intrauterine growth restriction
Congenital malformations
Infection
Birth asphyxia
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2
Q

When does the development of the CVS begin embryological?

A

3rd week

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3
Q

When does the heart start to beat?

A

Beginning 4th week

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4
Q

When is the critical period of heart development after fertilization?

A

Day 20-50

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5
Q

How does the foetus receive oxygenated blood?

A

Umbilical vein (ductus venosus)

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6
Q

What is the purpose of the ductus arteriosius?

A

Protects lungs against circulatory overload
Allows the right ventricle to strengthen
Carries low oxygen saturation blood

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7
Q

What is the ductus venosus?

A

Foetal blood vessel connecting the umbilical vein to the IVC

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8
Q

What type of blood does the ductus venosus usually carry?

A

Oxygenated blood

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9
Q

What happens to the ductus arteriosus and venosus during the first breath?

A

Becomes ligaments

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10
Q

What happens to the foramen ovale during the first breath?

A

Closes and leaves a depression

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11
Q

What happens to the umbilical vein and arteries during first breath?

A

Become ligaments

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12
Q

What is the normal BP at 1 hr age?

A

70/44

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13
Q

What is the normal BP 3 days after birth?

A

77 +/- 12

49 +/- 10

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14
Q

What is the usual RR in a full term newborn?

A

30-60/min

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15
Q

What is the normal HR in a full term newborn?

A

120-160bpm

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16
Q

What is tachycardia in a full term newborn?

A

> 160

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17
Q

What is a bradycardia in a full term newborn?

A

<100

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18
Q

What do newborns have to help with thermoregulation?

A

Brown fat

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19
Q

What is brown fat innervated by?

A

Sympathetic neurons

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20
Q

What can cold stress lead to in newborns?

A

Lipolysis

Heat production

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21
Q

What do newborns lack in terms of thermoregulation?

A

Shivering

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22
Q

What are the ways in which heat is lost?

A

Radiation
Convection
Evaporation
Conduction

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23
Q

What are non—invasive techniques to check a newborns breathing?

A

Blood gas
PaCO2 5-6kPa
PaO2 8-12kPa
Transcutaneous pCO2/O2 measurement

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24
Q

What are invasive techniques to check a newborns breathing?

A

Capnography
Tidal volume
Minute ventilation
Flow-volume loop

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25
When does physiological jaundice occur?
DOL 2-3
26
What does DOL stand for?
Day of life
27
When does physiological jaundice disappear?
DOL 7-10 in term infants | DOL 21 premature infants
28
How is physiological jaundice caused?
In newborns, jaundice tends to develop because of two factors—the breakdown of fetal hemoglobin as it is replaced with adult hemoglobin and the relatively immature metabolic pathways of the liver, which are unable to conjugate and so excrete bilirubin as quickly as an adult
29
What is a complication of physiological jaundice in newborns?
Kernicterus
30
What is kernicterus?
Bilirubin-induced brain dysfunction
31
What are treatments for severe jaundice in newborns?
Exchange transfusion | Phototherapy
32
Why is there weight loss in a newborn infant?
Shift of interstitial fluid to intravascular | Diuresis
33
Is it normal for a newborn to not pass urine for the first 24 hours?
Yes
34
Why is there increased loss through the kidney?
Slower GFR Reduced Na reabsorption Decreased ability to concentrate or dilute urine
35
How is there increased Insensible Water Loss (IWL)?
Via immature skin and breathing
36
On DOL 7 what is the RBC production compared to what it was in uterus?
10% of in uterus
37
What is the Hb at birth?
15-20g/l
38
What is the Hb at week 10?
11.4g/l
39
Why is there anaemia of prematurity?
Reduced erythropoesis Infection Blood letting
40
What are symptoms of anaemia in a newborn?
Pale skin Sluggish Poor feeding or tired when feeding Fast HR and rapid breathing when resting
41
What does SGA stand for?
Small for gestational age (SGA)
42
What does IUGR stand for?
Intra-uterine growth restriction (IUGR)
43
What are causes for small for date?
Maternal Foetal Placental Other - twin pregnancy
44
What is an example of a maternal cause for small for date?
Maternal pre-eclamptic toxemia (PET)
45
What are foetal causes of small for date?
``` Chromosomal (Edwards syndrome) Foetal infection (CMV) ```
46
What are some common problems in small for dates?
``` Perinatal hypoxia Hypoglycaemia Hypothermia Polycythaemia Thrombocytopenia GI problems ```
47
What are potential long term problems for small for dates?
Hypertension Reduced growth Obesity Ischaemic heart disease
48
What is a preterm baby?
<37wks
49
What is an extremely preterm baby?
<28wks
50
What is a low birth weight?
<2500g
51
What is a very low birth weight?
<1500g
52
What is an extremely low birth weight?
<1000g
53
What is RDS?
Respiratory distress syndrome
54
What is IVH?
Intra-ventricular haemorrhage
55
What is PVL?
Peri-ventricular leucomalacia
56
What is NEC?
Necrotising enetro-colitis
57
What is PDA?
Persistant ductus arteriosus
58
What is BPD?
Broncho-pulmonary displasia
59
What is ROP?
Retinopathy of prematurity
60
What is PHH?
Post-haemorrhagic hydrocephalus
61
What is NAS?
Neonatal abstinence syndrome
62
What is HIE?
Hypoxic-ischaemic encephalopathy
63
What is the prevention for RDS?
Antenatal steroids
64
What is the early treatment for RDS?
Surfactant Early extubation Non-invasive support (N-CPAP) Minimal ventiliation
65
What can be used as a respiratory stimulant in newborns?
Caffeine
66
What is the prevention for IVH (Intra-ventricular haemorrhage) of the brain?
AN steroids
67
What causes PDA (Persistant ductus arteriosus) in a newborn?
Pressure Ao>PA = L->R shunt
68
What happens as a result of L->R shunt in PDA?
Over-perfusion of lungs Lung edema Systemic ischaemia
69
What are the consequences of PDA?
Worsening of resp symptoms Retention of fluids (renal problems) GI problems
70
What happens in NEC (necrotising entero-colitis)?
Ischaemic and inflammatory changes | Necrosis of bowel
71
What is the management of NEC?
Surgical intervention | Conservative? - antibiotics and parenteral nutrition

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